| NPI | 1821575309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 308779) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308779-1) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2025-07-15 |